So we had another charming half day spent discussing professional boundaries and how they have a rather irritating habit of colliding with other boundaries. It comes up all the time in medicine, and we’ve all dealt with many cases that we either could identify as being oh-so-wrong, or maybe made us feel just… uncomfortable.

And with those discussions comes an assignment. Insta-blog post, woot!

(It’s not cheating, mlehhhh.)

But I had something a bit different to write about than what I think they intended…

Dissecting the boundaries between the professional and the personal has long been a favourite for discussion all throughout medical school. Over-sharing of personal information, how to handle friendships made in clinic… we’ve all run through the scenarios in our heads, if not in real life. But what I experienced, well I couldn’t make it fit perfectly into my classic “professional no-no” scenarios.

It was in the middle of a surgical rotation, brand new preceptor, brand new residents, brand new OR staff… I had to get to know them all, let them get to know me and, if I was lucky, impress one or two with my dazzling intellect. So I was anxious to make a great impression, given the short amount of time I had.

The scrub nurse working with us was over-tired from working an exceedingly long day just prior, as well as being up most of the night for reasons she didn’t elaborate on. She seemed to be the kind of person to be “wound tightly,” but in a chipper, upbeat sort of way. Busy with her hands and light on her feet.

The residents working with me that day seemed a bit more relaxed than me, but were still very conscious of the staff’s attention to detail and high standards.

My preceptor was brash, if somewhat laid back. And he was… inappropriate. Not in a mean-spirited way, but more in the jokey, wink-wink-nudge-nudge sort of way. Which essentially is the worst way. Because every attempted reproach or criticism can be laughed off. Stop taking things so seriously. It was just a joke.

Being the good, chameleon medical student, I picked up on his habits very quickly. I made a mental note that he enjoyed joking around and trading barbs. I noticed the way he stood, slouched back and arms folded on his chest – very relaxed yet confident and just a bit stubborn. It wasn’t long before I was half-emulating both.

Of course, the scrub nurse traded plenty of barbs with him, too. But over the first few hours, I noticed her getting more tired. She was less snappy with her retorts, tended to let more and more off-colour comments slide. She was getting fed up. And he was just getting started. And then the residents were in on it, too, adding their own (slightly more on-colour) comments. We got to chatting about things that scrub nurses “love,” like when you throw things at them or take stuff off the tray. “Oh, they just love it when you whistle for them.” He proceeded to demonstrate, with good comedic effect, judging by our appreciative chuckling. Then I said, “Ooh, they love it when you snap at them even more.”

It was meant as just another joke. But I regretted it even as the words were coming out of my mouth. The staff called her name and snapped obnoxiously. The nurse was busy grabbing materials and told him to stop, to just quit. Of course, he found that awfully funny. So he carried on. Her back was to us when she took a deep, shaky breath and sniffed a little. The heat rose in my face almost immediately and things got quiet. The staff muttered incredulously, “Is she actually crying?” She gave a long-suffering, annoyed response, sniffed once more, and then went back to work. In a matter of hours, she was back to her sassy self, almost as if it had never happened.

A line had been crossed and I’d been a part of what pushed her over the edge. What line that was, I had a hard time identifying at first. What gave a little more clarity was when a different staff came in the room during a particularly inappropriate moment (poking a resident with a pathology sample we had taken from the patient’s body just moments before). “Is that… a specimen?” The staff laughed with renewed gusto. The newcomer was clearly not as amused and wasn’t ashamed to show it.

After that, I realized I wasn’t obliged to find all the sexist jokes funny. I was allowed to be unimpressed. I still didn’t feel comfortable directly confronting him about his behaviour, but I felt comfortable enough to refuse to enable or take part. He might personally brand me as stiff or no fun, but at least my conscience would be clear.

Maybe it’s something that comes with age, maybe it’s something that comes with more training, or maybe it’s something you grow into at your own pace. But the confidence to acknowledge when things don’t feel right and at least avoid participating… it isn’t there all the time yet. But at least I know now that if I don’t impress and become chummy with my staff, that doesn’t mean I’ll be ostracized or degraded. On the contrary, hopefully I’ll gain a bit of self-respect, and (heaven only knows) maybe a touch of respect from others.

Total geek + family med resident = so much win.

Disclaimer: I am a 1st year resident. Officially I now know some stuff. However, this blog is for your entertainment (including, but not limited to, giggles, snorts of laughter, eye-rolling, fist pumping, and shouting at your computer screen) and is not a good substitute for a visit to your family doctor's office.

This is a blog for connecting med students and residents everywhere, so be sure to leave a comment and say hi! You could even leave flattering remarks and sassy quips. Up to you.

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